NY Times

“….The scientists found 52 suspected victims, and the rumor in the area was that the disease was caused by stepping in elephant dung. The investigators’ working assumption was that the worms that cause lymphatic filariasis had recently reached local mosquitoes.

Some victims reported that their legs began swelling as far back as 1980. Most had swelling in both feet, while filariasis tends to affect one leg. And most were farmers who lived above 4,000 feet, where mosquitoes are less common.

Also, only one victim had a swollen scrotum…..The victims had podoconiosis, a disease caused by walking barefoot in volcanic soils.

Such soils contains tiny, sharp, alkaline mineral crystals that work their way under the skin, causing fierce itching, and then are attacked by white blood cells, triggering inflammation that can develop over time into weeping sores and fibrous tissue…….”

PODO

Podoconiosis (podo) is a devastating and disfiguring disease caused when bare feet are exposed to volcanic soil. It affects millions of people in more than 15 countries, yet is preventable and treatable with simple washing and proper footwear. If farm workers are educated, podo can be eliminated in our lifetime.

Footwork, The International Podoconiosis Initiative
podo.org

Podoconiosis (or simply ‘podo’) is a form of elephantiasis or swelling of the lower leg triggered by prolonged exposure to irritant minerals in red clay soils. There is no infectious or contagious agent: no parasite, no bacterium, no virus is involved. It was classified as a Neglected Tropical Disease by the World Health Organization in 2011.

An estimated 4 million people in highland tropical Africa are affected with podoconiosis, and evidence suggests widespread endemicity in more than 15 countries throughout the world.

Although the disease is both preventable (by avoiding contact with irritant soil) and treatable (through simple, inexpensive foot hygiene and protection), there are as yet no government-backed assistance programs for addressing prevention and treatment of podoconiosis.

Individuals afflicted with podoconiosis suffer debilitating physical effects, including attacks when the leg becomes warm, painful and even more swollen, and are ostracised from their communities because of misconceptions about the cause of podoconiosis.

treatment

Field experience and a pilot study suggest the effectiveness of simple, inexpensive lymphoedema management (foot hygiene [washing with water and antiseptic], emollient, bandaging, exercise/massage, and socks & shoes) in reducing swelling, improving clinical appearance and quality of life for podoconiosis patients. A formal trial of this treatment is planned.

prevention

In highland volcanic areas (>1500m/5000ft), everyday foot washing and use of shoes or boots to protect feet against irritant soil is encouraged to help prevent podoconiosis.